Discovering Wellness Program

Discovering Wellness Program

(Please complete this application by August 12, 2019.)

Discover Wellness Application 2019

Name
Phone Number
Country
Address Line 1
City
State
Postal Code
Employer
Job Title
I consider myself a resident of the community of
Where did you learn about the Discover Wellness program?
Discovering Wellness begins with a weekend retreat from October 18 - 20 and then meets for a half day during the week each month from November 2019 through February 2020. We recommend discussing the program commitment with your employer before applying. Although not required, our hope is that many participants receive support from their employer in the form of paid leave and/or tuition. If selected into the program, which of the following apply?
If Other, please explain
Please briefly describe the responsibilities of your day to day work.
What do you hope to personally gain from this program?
If selected, how will you employ what you learn for the benefit of you and the community?
By submitting this application, I understand that if I am chosen as a participant I am expected to make a commitment to attend each program session